Effect of Preconception Hypothyroidism and First Diagnosed Hypothyroidism During Pregnancy on Offspring's Neurocognitive Function: A Prospective Cohort Study

Abstract

Background: This study was to evaluate maternal hypothyroidism before conception and first diagnosed during pregnancy on offspring’s cognitive performance. Method: This prospective cohort study have recruited women with hypothyroidism before pregnancy or first diagnosed during pregnancy in Obstetrics and Gynecology Hospital of Fudan University 2012-13. Their clinical characteristics, maternal thyroid function and pregnancy outcome were recorded. Gesell development diagnosis scale (GDDS) was applied for the evaluation of offspring’s neurocognitive function. It was conducted at six-month and one-year old. Results: A total of 78 women with hypothyroidism controlled and 107 with uncontrolled thyroid function in preconception group were recruited. 295 women first diagnosed during pregnancy were included as control group. In offspring’s Gesell assessment at six-month old, children in controlled hypothyroidism group performed a better adaptive ability compared to those firstly diagnosed during pregnancy (104.45±13.93 vs 99.38±17.71, P=0.022). At one-year old, children in preconception uncontrolled group performed inferior to those those firstly diagnosed during pregnancy, in the GDDS full-scale DQ (100.61±5.96 vs 105.14±7.40, P=0.001), and fine motor, adaptability, language and social emotional response category. Full-scale quotation of Gesell scale in clinical hypothyroidism group was of no statistical difference compared to that of subclinical hypothyroidism (P=0.309). Conclusions: Offspring’s impaired neurodevelopment in women with uncontrolled thyroid function suggested the benefits of screening preconception hypothyroidism. Trial registration: The registered ClinicalTrials ID was NCT01744743. Funding Statement: This study was funded by the grants from Health industry special funds for Public Benefit Research Foundation from the Ministry of Health, People's Republic of China (201002013), the National Science Fund of China (81270712), National Science Foundation for Young Scholars of China (81200449), National Science Foundation for Young Scholars of China (81300506), National Key Basic Research Plan of China (973 Plan) (2010CB529500), National Science Foundation for Young Scholars of Shanghai (13ZR1452000), the Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, and the Key Specialty Project of the Ministry of Health, People's Republic of China. Declaration of Interests: The authors report no conflict of interest. Ethics Approval Statement: The study was reviewed and approved by the Ethics and Research Committee of Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China, and all women have signed the consent.